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The patient should lie completely on his/her back. Both femoral
arteries should be palpated for site selection and consequence
assessment. The knee on the same side of the insertion site
should be flexed and the thigh abducted. Place the foot across
the opposite leg. The femoral vein is then posterior/medial to
the artery.
Note: The incidence of infection may be increased with femoral vein
insertion.
•
Confirm final position of catheter with chest x-ray. Routine x-
ray should always follow the initial insertion of this catheter to
confirm proper tip placement prior to use.
•
Femoral catheter tip placement is recommended at the junction
of the iliac vein and the inferior vena cava.
DIRECTIONS FOR SELDINGER INSERTION
•
Read instructions carefully before using this device. The
catheter should be inserted, manipulated, and removed by a
qualified, licensed physician or other qualified health care
professional under the direction of a physician.
•
The medical techniques and procedures described in these
instructions for use do not represent all medically acceptable
protocols, nor are they intended as a substitute for the
physician's experience and judgment in treating any specific
patient.
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Use standard hospital protocols when applicable.
1.
Strict aseptic technique must be used during insertion,
maintenance, and catheter removal procedures. Provide a
sterile operative field. The Operating Room is the preferred
location for catheter placement. Use sterile drapes, instruments,
and accessories. Shave the skin above and below the insertion
site. Perform surgical scrub. Wear gown, cap, gloves, and mask.
Have patient wear mask.
2.
The selection of the appropriate catheter length is at the sole
discretion of the physician. To achieve proper tip placement,
proper catheter length selection is important. Routine x-ray
should always follow the initial insertion of this catheter to
confirm proper placement prior to use.
3. Administer sufficient local anesthetic to completely anesthetize
the insertion site.
4.
Make a small incision at the exit site on the chest wall
approximately 8-10cm below the clavicle. Make a second
incision above and parallel to the first, at the insertion site.
Make the incision at the exit site wide enough to accommodate
the cuff, approximately 1cm.
5.
Use blunt dissection to create the subcutaneous tunnel
opening. Attach the catheter to the trocar. Slide catheter
tunneling sleeve over the catheter making certain that the
sleeve covers the arterial holes of the catheter. Insert the trocar
into the exit site and create a short subcutaneous tunnel. Do
not tunnel through muscle. The tunnel should be made with
care in order to prevent damage to surrounding vessels.
5a. For Femoral Vein Insertion: Create subcutaneous tunnel with
the catheter exit site in the pelvic region.
Warning: Do not over-expand subcutaneous tissue during
tunneling. Over-expansion may delay/prevent cuff in-growth.
6.
Lead catheter into the tunnel gently. Do not pull or tug the
catheter tubing. If resistance is encountered, further blunt
dissection may facilitate insertion. Remove the catheter from
the trocar with a slight twisting motion to avoid damage to the
catheter.
Caution: Do not pull tunneler out at an angle. Keep tunneler
straight to prevent damage to catheter tip.
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